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2019冠状病毒病封锁措施对血糖控制的影响:一项在三级医疗机构开展的回顾性观察队列研究

Impact of SARS-CoV-2 Lockdown on Glycaemic Control: A Retrospective Observational Cohort Study in a Tertiary Setting.

作者信息

Zechmann Stefan, Hotz Leana, Di Gangi Stefania, Baumgartl Klaus, Plate Andreas, Potlukova Eliska

机构信息

Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, 4031 Basel, Switzerland.

Institute of Primary Care, University and University Hospital Zurich, 8091 Zurich, Switzerland.

出版信息

J Clin Med. 2021 Sep 10;10(18):4098. doi: 10.3390/jcm10184098.

Abstract

We analysed the effects of Swiss national lockdown due to the COVID-19 pandemic on the glycaemic control in patients with diabetes mellitus. In a retrospective observational cohort study with observation period 16 December 2018-27 July 2020, we included tertiary care patients with diabetes and at least one glycated haemoglobin A1c (HbA1c) measurement before and after the lockdown beginning. Main outcome measure was change in HbA1c after the lockdown. We included 1078 patients (86% diabetes type 2) with a mean HbA1c of 55.63 mmol/mol (7.24%). Glycaemic control was susceptible to seasonal changes with higher mean HbA1c in winter as compared to spring (57.49 mmol/mol (7.41%) vs. 55.52 mmol/mol (7.23%), = 0.013). The lockdown did not affect the mean HbA1c values of all patients. However, we found a higher proportion of type 2 diabetes patients with a worsening HbA1c after the lockdown as compared to the year before (32% vs. 22.9%, = 0.02). In a mixed-model regression multivariable analysis, inappropriate alcohol intake and hypothyroidism were associated with an increase in HbA1c after the lockdown. In conclusion, the national lockdown had no effect on overall mean HbA1c values but affected a proportion of type 2 diabetes patients with worsening HbA1c, whose individual risk factors were identified.

摘要

我们分析了因新冠疫情实施瑞士全国封锁对糖尿病患者血糖控制的影响。在一项回顾性观察队列研究中,观察期为2018年12月16日至2020年7月27日,我们纳入了三级护理的糖尿病患者,这些患者在封锁开始前后至少有一次糖化血红蛋白A1c(HbA1c)测量值。主要结局指标是封锁后HbA1c的变化。我们纳入了1078例患者(86%为2型糖尿病),平均HbA1c为55.63 mmol/mol(7.24%)。血糖控制易受季节变化影响,冬季的平均HbA1c高于春季(57.49 mmol/mol(7.41%)对55.52 mmol/mol(7.23%),P = 0.013)。封锁并未影响所有患者的平均HbA1c值。然而,我们发现与前一年相比,封锁后HbA1c恶化的2型糖尿病患者比例更高(32%对22.9%,P = 0.02)。在混合模型回归多变量分析中,饮酒不当和甲状腺功能减退与封锁后HbA1c升高有关。总之,全国封锁对总体平均HbA1c值没有影响,但影响了一部分HbA1c恶化的2型糖尿病患者,并确定了其个体风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c51/8466167/06be6f7cd937/jcm-10-04098-g001.jpg

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